[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR455.106]



[Page 338]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 455_PROGRAM INTEGRITY: MEDICAID--Table of Contents

 

   Subpart B_Disclosure of Information by Providers and Fiscal Agents

 

Sec.  455.106  Disclosure by providers: Information on persons 



convicted of crimes.



    (a) Information that must be disclosed. Before the Medicaid agency 

enters into or renews a provider agreement, or at any time upon written 

request by the Medicaid agency, the provider must disclose to the 

Medicaid agency the identity of any person who:

    (1) Has ownership or control interest in the provider, or is an 

agent or managing employee of the provider; and

    (2) Has been convicted of a criminal offense related to that 

person's involvement in any program under Medicare, Medicaid, or the 

title XX services program since the inception of those programs.

    (b) Notification to Inspector General. (1) The Medicaid agency must 

notify the Inspector General of the Department of any disclosures made 

under paragraph (a) of this section within 20 working days from the date 

it receives the information.

    (2) The agency must also promptly notify the Inspector General of 

the Department of any action it takes on the provider's application for 

participation in the program.

    (c) Denial or termination of provider participation. (1) The 

Medicaid agency may refuse to enter into or renew an agreement with a 

provider if any person who has an ownership or control interest in the 

provider, or who is an agent or managing employee of the provider, has 

been convicted of a criminal offense related to that person's 

involvement in any program established under Medicare, Medicaid or the 

title XX Services Program.

    (2) The Medicaid agency may refuse to enter into or may terminate a 

provider agreement if it determines that the provider did not fully and 

accurately make any disclosure required under paragraph (a) of this 

section.